Debra Madden, a clinical-applications systems analyst for Associated Neurologists, interviewed geneticist and pathologist Gabriel Bien-Willner, MD, PhD, FCAP, in an 8,000-word piece for The American Journal of Managed Care titled, “Do We Need to Realign Evidence-Based Versus Precision Medicine?”
Throughout the piece, Bien-Willner expressed a number of provocative views on:
- The ineffectiveness of evidence-based medicine: Madden quoted a recent statement Bien-Willner made as an audience member at the annual meeting of the American Society of Clinical Oncology: “I would argue that evidence-based medicine is incompatible with precision medicine and, as currently practiced, is not effective for cancer care.”
- The challenges of oncologists actually understanding genetic data: Bien-Willner believes that technology has a critical role to play in the effort to “simplify the workflow and knowledge gaps,” and said that any expectations for oncologists to have an expert understanding of genomics are misplaced and a threat to the success of healthcare’s ongoing precision-medicine journey.
- The relationship between evidence-based medicine and precision medicine: Bien-Willner contends that “these are 2 opposing perspectives and methods for deciding what proper care is.” He argued that while the former relies on “empirical statistical inference,” the latter relies on “logic and our understanding of the mechanisms that underlie disease,” and he reiterated the lack of compatibility between today’s approach to evidence-based medicine and precision medicine.